High Dose Intravenous Vitamin C for Preventing The Disease Aggravation of Moderate COVID-19 Pneumonia. A Retrospective Propensity Matched Before-After Study

DOI record: { "DOI": "10.3389/fphar.2021.638556", "ISSN": [ "1663-9812" ], "URL": "http://dx.doi.org/10.3389/fphar.2021.638556", "abstract": "<jats:p><jats:bold>Background:</jats:bold> Coronavirus disease 2019 (COVID-19) pandemic is continuing to impact multiple countries worldwide and effective treatment options are still being developed. In this study, we investigate the potential of high-dose intravenous vitamin C (HDIVC) in the prevention of moderate COVID-19 disease aggravation.</jats:p><jats:p><jats:bold>Methods:</jats:bold> In this retrospective before-after case-matched clinical study, we compare the outcome and clinical courses of patients with moderate COVID-19 patients who were treated with an HDIVC protocol (intravenous injection of vitamin C, 100 mg/kg/day, 1 g/h, for 7 days from admission) during a one-month period (between March 18 and april 18, 2020, HDIVC group) with a control group treated without the HDIVC protocol during the preceding two months (January 18 to March 18, 2020). Patients in the two groups were matched in a 1:1 ratio according to age and gender.</jats:p><jats:p><jats:bold>Results:</jats:bold> The HDIVC and control groups each comprised 55 patients. For the primary outcomes, there was a significant difference in the number of patients that evolved from moderate to severe type between the two groups (HDIVC: 4/55 vs. control: 12/55, relative risk [RR] = 0.28 [0.08, 0.93], <jats:italic>P</jats:italic> = 0.03). Compared to the control group, there was a shorter duration of systemic inflammatory response syndrome (SIRS) (<jats:italic>P</jats:italic> = 0.0004) during the first week and lower SIRS occurrence (2/21 vs 10/22, <jats:italic>P</jats:italic> = 0.0086) on Day 7 (6–7 days after admission). In addition, HDIVC group had lower C-reactive protein levels (<jats:italic>P</jats:italic> = 0.005) and higher number of CD4<jats:sup>+</jats:sup> T cells from Day 0 (on admission) to Day 7 (<jats:italic>P</jats:italic> = 0.04).” The levels of coagulation indicators, including activated partial thromboplastin time and D-dimer were also improved in the HDIVC compared to the control group on Day 7.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> HDIVC may be beneficial in limiting disease aggravation in the early stage of COVID-19 pneumonia, which may be related to its improvements on the inflammatory response, immune function and coagulation function. Further randomized controlled trials are required to augment these findings.</jats:p>", "alternative-id": [ "10.3389/fphar.2021.638556" ], "author": [ { "affiliation": [], "family": "Zhao", "given": "Bing", "sequence": "first" }, { "affiliation": [], "family": "Liu", "given": "Min", "sequence": "additional" }, { "affiliation": [], "family": "Liu", "given": "Ping", "sequence": "additional" }, { "affiliation": [], "family": "Peng", "given": "Yibing", "sequence": "additional" }, { "affiliation": [], "family": "Huang", "given": "Jun", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Mengjiao", "sequence": "additional" }, { "affiliation": [], "family": "Wang", "given": "Yihui", "sequence": "additional" }, { "affiliation": [], "family": "Xu", "given": "LiLi", "sequence": "additional" }, { "affiliation": [], "family": "Sun", "given": "Silei", "sequence": "additional" }, { "affiliation": [], "family": "Qi", "given": "Xing", "sequence": "additional" }, { "affiliation": [], "family": "Ling", "given": "Yun", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Jian", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Wenhong", "sequence": "additional" }, { "affiliation": [], "family": "Mao", "given": "Enqiang", "sequence": "additional" }, { "affiliation": [], "family": "Qu", "given": "Jieming", "sequence": "additional" } ], "container-title": "Frontiers in Pharmacology", "container-title-short": "Front. Pharmacol.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2021, 4, 22 ] ], "date-time": "2021-04-22T11:55:28Z", "timestamp": 1619092528000 }, "deposited": { "date-parts": [ [ 2021, 4, 22 ] ], "date-time": "2021-04-22T11:55:33Z", "timestamp": 1619092533000 }, "funder": [ { "DOI": "10.13039/501100003399", "doi-asserted-by": "publisher", "name": "Science and Technology Commission of Shanghai Municipality" }, { "DOI": "10.13039/501100018920", "doi-asserted-by": "publisher", "name": "Ruijin Hospital" } ], "indexed": { "date-parts": [ [ 2023, 12, 15 ] ], "date-time": "2023-12-15T11:43:30Z", "timestamp": 1702640610060 }, "is-referenced-by-count": 27, "issued": { "date-parts": [ [ 2021, 4, 22 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 4, 22 ] ], "date-time": "2021-04-22T00:00:00Z", "timestamp": 1619049600000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fphar.2021.638556/full", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1965", "original-title": [], "prefix": "10.3389", "published": { "date-parts": [ [ 2021, 4, 22 ] ] }, "published-online": { "date-parts": [ [ 2021, 4, 22 ] ] }, "publisher": "Frontiers Media SA", "reference": [ { "DOI": "10.1136/bmj.m4779", "article-title": "Update to living WHO guideline on drugs for covid-19", "doi-asserted-by": "publisher", "first-page": "m4779", "journal-title": "Bmj", "key": "B1", "volume": "371", "year": "2020" }, { "DOI": "10.1016/j.medidd.2020.100064", "article-title": "Serum levels of vitamin C and vitamin D in a cohort of critically ill COVID-19 patients of a north American community hospital intensive care unit in may 2020: a pilot study", "author": "Arvinte", "doi-asserted-by": "publisher", "first-page": "100064", "journal-title": "Med. 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